Tag Archives: WHO

“In a quality city, a person should be able to live their entire life without a car, and not feel deprived” – Paul Bedford, City of Toronto Planning Director (2014)

Improvements to the design and layouts of streets and cities can have a significant impact on encouraging more of us to walk. However, many people living in cities face a significant number of barriers to being physically active where they live, particularly in relation to walking. Pathways and public spaces such as parks and throughways are often unappealing, unsafe, congested, traffic filled, noisy or for some completely inaccessible, which leads to a reliance on vehicular travel and a reluctance to be physically active within the city environment.

Walkable environments consider not only the physical design of routes, but also features and facilities that are inclusive of the widest possible range of needs; for example, places for people to rest along their journeys (including well designed seats and benches), accessible toilet facilities, signage and street design that is sensitive to a range of needs and that can help with orientation and wayfinding. However, the benefits are clear across the board when it comes to trying to make our cities more walkable (and as a result healthier). This blog post outlines a few of these potential benefits, and considers how planners can get involved in realising some of them through effective planning and design in their own cities.

Social benefitsSafe, walkable, environments can provide opportunities for people of all ages and abilities to stay socially connected and engaged. This can be particularly helpful in communities with a lot of children, older people or vulnerable adults. Having areas that are known to be safe can help to encourage people to leave their homes, reducing the impact of loneliness and social isolation, and improving their sense and feeling of community in their local area, which in turn can help with health and wellbeing and community cohesion.

Health benefitsWalking is good for us! In August this year a survey by Public Health England revealed that four in 10 middle-aged adults fail to manage even one brisk 10-minute walk a month. This despite research showing that walking each day can rapidly reduce risk of health conditions such as stroke and heart attack. Promoting active lifestyles through encouraging walking has also been shown to help tackle the growing issue of obesity, particularly among younger people. Walking can also be good for mental health, particularly when it is done as a group. Increasingly, walking interventions are being prescribed as part of social prescription initiatives to help people regain health, fitness and confidence. But in order for these to be effective, spaces and suitable environments for walking need to be made available.

Environmental benefitsFor many cities, London, Manchester and Glasgow included, congestion and air pollution are major issues. Creating walkable cities, and encouraging walking, cycling and other more environmentally friendly modes of transport can have a significant impact on the levels of pollution within an area. Reducing vehicle use can also have an impact on noise, water, thermal and light pollution in our cities too. Some attempts are being made to reduce the level of pollution in our cities – vehicles in central London have been subject to a congestion charge for a number of years. However, recent developments and attempts to reduce the high levels of air pollution in the city have led to the introduction of the “T-Charge”. It has been suggested that the money raised from this charge could be used to fund green transport initiatives, and this includes improving cycle and walkways and making streets more easy to navigate on foot.

Economic benefitsWalkable spaces can act as a catalyst for local economic vitality, regeneration and tourism. Research has shown that improving public spaces, and creating an environment which encourages more people to walk safely, (and free from the noise, smell and feelings of claustrophobia that can come with high levels of car traffic) has a significant and positive impact on businesses, resulting in people spending more time, but also more money in shops and town centres.

Creating walkable cities: what can be done to helpPlanners and city officials are increasingly aware of the need to promote more open, safe and accessible public spaces in new development areas. However, some cities have already implemented practices that could be taken forward in the future. Organisations like Living Streets have produced road maps and blueprints of how cities can use planning to improve public spaces, make them walker friendly and reduce reliance on vehicles. Consultancies like Arup have also produced research on the benefits of creating “walkable cities” and in 2014 RTPI launched their own report on the benefits of planning for “healthier cities” (which includes provision for making cities more walkable). In 2017 the World Health Organisation (WHO) published a briefing on transforming public spaces to promote physical activity in cities. There are a number of ways in which planners and city planning teams can have a positive impact on promoting change to encourage more walking in our cities including:

Create walkable neighbourhoods – In Melbourne a “local connectivity plan” was introduced in 2014. The plan was used to build a network of neighbourhoods which had social, leisure and retail facilities within a 20 minute walk of people’s homes.

Prioritise walking, and “walkable spaces” in development and regeneration plans – The mayor of London appointed a walking and cycling commissioner in 2017, whose role is to make walking and cycling easier and safer across the capital. The mayor’s new ‘healthy streets’ approach is a commitment to a system of healthy streets and strategies that will help Londoners use cars less and walk, cycle and use public transport more.

Make walking safe – Designing walkways and footpaths that incorporate wide, well lit pathways, well signposted and nicely designed and maintained routes has been shown to be one of the main factors in encouraging people to walk more within their local area.

Make walking easy (and fun) – Go Jauntly is a new walking app that uses photographs rather than maps to guide users on routes around woods and byways. Walkers can add their own routes, and it is hoped that it the app will “increase the social appeal of people walking together” coming up with new routes within their own neighbourhoods, or areas they like to walk in.

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Talking about sexuality and intimacy can be an awkward and, for some, taboo subject, particularly when the people we are discussing are parents or elderly relatives.

However, in a care setting, where a relative has been moved into care, sexuality, sexual needs and questions around intimacy often remain un-talked about and un-catered for, and can create an awkward situation for residents, relatives and care staff.

For many people, intimacy is a ‘normal everyday’ part of life. But when moving into residential care, for many people, that is lost. They feel their privacy is taken away and their ability to conduct life as they had before needs to change as a result of moving from their home. The onset of conditions such as dementia in later life can also make other people uneasy about the idea of continuing with intimate relationships, or indeed starting new ones later in life. One of the aims of the research conducted by a team at Manchester University on older people’s understanding of sexuality (OPUS project) is to look at erotophobia, or a fear of older people’s sexuality (within the remit of feelings and beliefs on sexuality more generally).

The loss of identity through sexual expression can be even more explicitly felt by members of the LGBT community, many of whom, studies have found, have felt the need to ‘go back into the closet’ upon entering residential care.

In 2010 the World Health Organisation (WHO) published a set of sexual rights. In this the right of the individual to choice is key and something which care homes must still respect.

Sexual rights in older people was also the subject of a report by the Royal College of Nursing who commented that “when someone moves into a care home, to all intents and purposes the private space of their room is exactly that, their private space and provided any acts are consensual care homes should facilitate the wishes of residents to the fullest extent.” Within a human rights context, adults living in residential settings, unless they have had certain rights and freedoms curtailed or restricted by the law, generally have the same basic rights and freedoms as any citizen to live their lives as they wish. This includes possibly doing things that others might consider to be unwise or inappropriate.

In addition, although many decisions about care within a care home setting are taken in consultation with the family of the resident, carers and care home managers must also remember that they have a duty to their patient, and there is a level of patient-carer confidentiality which carers should be mindful of when discussing topics such as sex, sexuality or intimacy.

However, in that context it is also the case that care home workers have a duty of care, to protect vulnerable people from abuse, exploitation and situations which they might find distressing. The International Longevity Centre have produced a guide which contains advice around intimacy and sexuality in care homes, looks at intimacy in older people, (particularly older people with dementia) and the position of people within the LGBT community who move into residential care.

Many within the LGBT community have expressed a feeling of discrimination or anxiety about their sexuality on entering residential care and as a result there are suggestions of LGBT only residential care homes being created, with one proposed for either London or Brighton in the next few years.

The legality behind many of the decisions taken in care homes is set out in law, including definitions of consent, abuse, exploitation, violence. However, the individual practices of care homes regarding policy is often set out and implemented at the discretion of care home managers and staff and it is their responsibility to ensure that they have an effective and consistent policy in place when it comes to sexuality, intimacy and relationships more generally.

They also have a responsibility to ensure that staff are suitably trained to tackle any issues which may arise, answer any questions from residents or family members and recognise boundaries and levels of appropriateness while still delivering care to residents. Care workers must balance delivering effective care with promoting personal emotional and mental well being, allowing residents a level of freedom and personal choice while ensuring adequate safeguards are in place. This is not an easy task. However, more research is currently being conducted, and improved training for staff is also being increasingly offered as the norm.

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